Psychological and Physical Addiction: A simplistic misconception?

[Dickon]

Although I have found a couple of threads discussing what is addiction, they have both died a death, and there's a specific issue I'd like to start a discussion about. In the amphetamines addiction and recovery section someone asked "are amphetamines addictive?", to which I gave the unusually brief reply: "Is the Pope Catholic?" Of course they fucking are!

The trouble is, if you ask me, people are hung up on the idea that there are two fundamentally different types of addiction: the physical and the psychological, and somehow the latter are really only in one's head, so stop whining and get on with life. I've seen this kind of post when it comes to amphetamines and I think it's not only exceeding unhelpful to someone trying to quit, I further think it's out and out wrong.

My cat has experience of various "addictive" substance used in an addictive way: essentially opiates (heroin, morphine, methadone etc.), benzodiazepines (diazepam/Valium, xanax/Alprazolam etc), alcohol, amphetamines, (crack) cocaine, nicotine and caffeine. He also went through a period of using cannabis on a daily basis, brief periods of nitrous oxide use, and took a fair whack of LSD. He also sniffed glue and other solvents, and took barbiturates, although never for extended periods.

What can I report back on his behalf? Clearly some have experienced pets (to a greater of lesser extent). Such owners can form their own opinions, and to my view such experience is invaluable. However, it might also be a hindrance in that it leads to a vastly subjective point of view. I need only remember a friend of mine taking just one toke from a crack pipe to realise we are not all the same.

But what of addiction? Opiates are one of the classically "physically addictive" drugs. But if we stop a minute and think, the withdrawal symptoms are caused by a lack of sufficient endorphins to fit the receptors in the brain. This occurs entirely inside one's head. So, if it is a physical problem it is one limited in scope to the brain (we shall ignore the peripheral opiate receptors in the gut and perhaps others. This is a minor issue). The somatic manifestations (i.e. gooseflesh, flu-like symptoms etc) are caused by disfunctional brain function not the other way round. So, neurons fire in an off-whack sort of way due to a chemical "imbalance" in the brain.

Let us now look at a "psychologically addictive" drug: classic examples are the stimulants. Here we are dealing with dopaminergic drugs, that cause dopamine to be released, or inhibit the reuptake of dopamine. When these are stopped, at least after long term use the dopamine system in the brain is screwed up and long-term depression, somnolence, apathy, suicidal ideation, over-eating, are among the resultant effects. Perhaps imbalance in this system of the brain doesn't lead to much overt change in the rest of the body, but stimulant users do tend to have a remarkably hard time quitting, and staying quit.

Benzodiazepine use and withdrawal affects the GABA system. Here the fits that withdrawal can cause manifest physically, but the reason there are physical manifestations are because the electrical activity of the brain (i.e. the mind or psyche in some broad sense, without making philosophical distinctions) is yet again out of whack.

Cannabis affects the endogenous cannabinoid receptor system I'd imagine, and some seem to have a great difficulty stopping that. Nicotine is often quoted as being "physically addictive", but how so? There is no "gooseflesh". alcohol seems to be addictive long before there are any physical withdrawal symptoms. Caffeine has the physical withdrawal symptom of, wait for it, headaches: oh no, that's all in the head. How confusing!

All in all my cat tells me each substance has its own flavour of addictiveness, and this flavour can act on different individuals in different ways. There is no way my cat could smoke crack, shoot, smoke or eat amphetamines, and not take more if available. At that point the brain is out of whack (again!). My cat seems to experience two distinct phases to stimulant "withdrawal". The first is the overwhelming craving associated with not having the drug, for an hour or several in the case in the case of crack, and for a day or several in the case of amphetamines. This is followed by more chronic depression, sleepiness, apathy, cravings etc.

Why do so many people start using opiates once the "physical withdrawals" are over?

Well, I don't have all the answers, but I feel strongly that by thinking about addiction in the physical/psychological sense, we are missing the point, and missing the very real physical and long-term changes in brain chemistry that almost certainly occur with long-term use and cessation of almost any psychoactive substance. Any so-called physical withdrawal symptoms are consequences of the particular nature of the imbalance in brain chemistry caused by cesation of the drug in question. As far as I know the drugs with dangerous withdrawals are those for which the brain has the greatest short-term difficulty re-establishing equilibrium, to the extent that homeostasis can't occur and death follows.

Oddly, and I doubt I'd be talking purely hypothetically here, a drug that could be used in greater and greater quantities to regulate, say, liver function, but that upon abrupt withdrawal would throw the liver so off kilter that physical manifestations would occur is unlikely to be considered addictive by most standards.

What does the rest of DF think?

Dickon

Reputation Comments on this post:

	Great topic, I'd love to see an intelligent conversation or even debate on this subject
	Fantastic information,a lot of effort went into this

[chillinwill]

Of course Amphetamines are addictive....Although Red Rock doesn't have as much experience in the Amphetamine/Methamphetamine section as he has experienced in Opiates, he was addicted to crystal methamphetamine for a short while (couple of months) and he knows damn well that they can be addictive as hell. Of course crystal methamphetamine and prescription uppers such as Adderall and methylphenidate are different based on dosage but they still are basically straight amphetamine or methamphetamine at just lower dosages than what someone would buy off the street.

By the way, its my 2,000th post!

[rokman nash]

From long time personal experience my friend Dave can break these down into 2 major classes.this is all from Davis personal experience, Physical/physiological addiction occurred for him with all major opiates IE: heroin,oxycontin,codeine,vicodin,percocet,lortab, hydrocodone,methadone. Amphetamines IE: crack cocaine,methamphetamine,adderall,ritalin,provigil. Of course there's tobacco and alcohol also....I know on the spur of the moment i'm leaving stuff out.

Physcolgical only, cocaine(powder),didrex, give me a day and i'll fill out the list.

[Nature Boy]

Addiction is a complex issue. What exactly is addiction? Classical physical addiction is probably best demonstrated by drugs like alcohol or benzodiazepines in that the dose increases significantly in order to reward the user but cessation of use can result in a dangerous withdrawal, potentially leading to death in worst case scenarios. Not even heroin qualifies as being classically addictive in this sense because, although many consider it to be the most addictive drug of all, its withdrawal won't necessarily lead to the body shutting down. Instead, the body will use defence mechanisms such as fever and other reactions similar to someone dealing with influenza. Many people would contend that the cravings are incredibly difficult to ignore however. The increase in tolerance with regular use is also a massive risk when it comes to assessing dosage. An addict who takes large doses regularly might go a week without supply and then underestimate their next hit due to the time that had elapsed in between.

Even with a more benign substance like cannabis, different opinions are held when it comes to addiction. A psychiatrist would almost definitely point towards psychological addiction whereas a general practitioner might not see much truth in this given the lack of hard evidence. With a substance that does not display a definite physical withdrawal, we're entering the territory of gambling addiction or sex addiction. This is where it has less to do with a substance as such, but where the user may become preoccupied with the effects or rewards of using whatever substance or partaking in whatever activity. But should we call this addiction, preoccupation, infatuation or what? I don't know. It might be a terminology issue more than anything.

Reputation Comments on this post:

you have some good points and information here in this post

[Routemaster Flash]

Interesting post, Dickon. SWIM fortunately doesn't have any experience of being addicted to anything (or so he thinks - he never goes more than a few hours without a cup of tea! ) but he thinks a quote from William Burroughs, who knew a thing or two about drug habits, is pertinent here:

"[the diabetic] needs insulin to maintain a normal metabolism. The addict needs morphine to maintain a morphine metabolism, and so avoid the excruciatingly painful return to a normal metabolism."

[electrolingus]

Reality is always real for the one who experiences it. Any time brain chemistry, neural activity,etc... is altered, one must experience a change while these things are getting back to normal. The physical or psychological effects are just different or manifest themselves in different ways.

Stimulants such as cocaine or methamphetamine do have physical withdrawal symptoms. These may not be as severe as the physical withdrawal associated with other drugs like opioids, benzodiazepines, or alcohol, but never the less they do exist. If one can't keep one's eyes open while kicking speed, that is a physical symptom.

On the other hand, opioid withdrawal has it's fair share of psychological symptoms, severe depression being the main one along with mood swings and anxiety.

My hamster thinks the big thing here is separating the two. My hamster in his addictive times would sometimes wake up in the morning and not feel great, but he was far from sick. You see, the hamster always knew that all he had to do was open the night stand drawer and his heroin would be there. One time, he opened up the drawer and found that someone had stolen his stash. Before the hamster knew the stash was gone, he felt somewhat fine, but once the reality of the situation set in, he quickly got ill. Vomiting bile, loose bowels, couldn't sit still. So what was that? He obviously wasn't "physically" in withdrawal before opening the drawer.

What of people who when they come in possession of a drug, they begin to manifest certain physical symptoms? If the hamster would score some cocaine, sometimes his bowels would loosen after doing so. When the hamster came to possess heroin after long periods of abstinence, he would exude some opioid withdrawal symptoms while doing so.

The mind is a powerful thing. Trying to separate the physical from the psychological can be a bit tricky. As far as why do people start using opiates again after the withdrawals are over. Well first, the physical withdrawal is gone, but is the physical addiction gone? When the hamster is run down and in the doldrums, he knows that a shot of heroin would make him feel better. Give the hamster an opioid and he is ready to take on the world. It actually stimulates him. This is why, at least for him, he returns to opioid use. He is attached to it by an invisible string. The use of an opioid substance in the hamster is kind of like putting back something that was missing. It fits and it's comfortable. The hamster could sit and watch paint dry if he was under the influence of an opioid.

Keep in mind that SWIM is only talking about opioids, coke, and meth. The withdrawal from benzo's, barbiturates, and alcohol are much worse in relative comparison.

[drug-bot]

since the 1970s/80's the idea of addiction slowly (very slowly) began to change, prior to that addiction was exclusively referred to physically addictive substancses such as opiates, alcohol, barbituates, and benzodiazipines; while substances such as cocaine, nicotine, and amphetamines where simply considered habituating. not until the american psycological association newer version of there field manual the DSM, the DSM-IV (in 1994) the word and concept of addiction as only applying to physically addictive substances changed to the now broadly accepted term substance abuse, which refers to any addictive drug or one in which one is addicted to whether they are physically addictive or not.

[Spucky]

Originally Posted by Dickon

Why do so many people start using opiates once the "physical withdrawals" are over?

What does the rest of DF think?

Dickon

Because the few of the "degenerated" Drug-Receptors are still active
but in a "Stand By Mode",
if we have a "Kindling-Process" here we will see a big explosion
that lead into a immense Craving!
(like a Post-Traumatic Stress Disorder)
If People start to use Heroin once we will discover a multiple increase/
Degeneration of Mu- and Kappa Receptors.
The User is addicted again!

Have a look to Mrs. Google and search for "Kindling Process"
because swim English is not well enough for Medical Theses!
Swim guess it will help to understand at least the Neurobiological Model!

Sociological Affects are made by that Neurological Model
and Neurological Affects Change again the Sociological Model.
So we have a perfect self-running Disease,
like Parasites who are farming our Brain!

Edit: This is only the "Western View",
Many People in Asia have a total different Analysis of Addiction!

[EscapeDummy]

Originally Posted by drug-bot

since the 1970s/80's the idea of addiction slowly (very slowly) began to change, prior to that addiction was exclusively referred to physically addictive substancses such as opiates, alcohol, barbituates, and benzodiazipines; while substances such as cocaine, nicotine, and amphetamines where simply considered habituating. not until the american psycological association newer version of there field manual the DSM, the DSM-IV (in 1994) the word and concept of addiction as only applying to physically addictive substances changed to the now broadly accepted term substance abuse, which refers to any addictive drug or one in which one is addicted to whether they are physically addictive or not.

We should also realize that we have come an incredibly long way about understanding the brain in psychological and neurological perspectives compared to 1994. the DSM IV is likely archaic compared to our current knowledge in the year 2009. Also, I'm not super-informed on the subject of addiction, but I believe modern psychologists have classified some drugs to be "physiologically" addictive? Would anyone like to clarify how that is seperate from a psychological addiction?

[Routemaster Flash]

Originally Posted by EscapeDummy

We should also realize that we have come an incredibly long way about understanding the brain in psychological and neurological perspectives compared to 1994. the DSM IV is likely archaic compared to our current knowledge in the year 2009. Also, I'm not super-informed on the subject of addiction, but I believe modern psychologists have classified some drugs to be "physiologically" addictive? Would anyone like to clarify how that is seperate from a psychological addiction?

My (layman's) understanding is that the distinction is made as follows: a drug is physiologically addictive if a cessation of habitual use causes physical withdrawal symptoms, as the user's body has actually got used to the substance and can't work properly without it; psychological addiction just means the user feels strong cravings for the drug.

I think this is probably a bit of a simplification too, as 'cravings' could be so strong as to produce psychosomatic symptoms (after all, any subjective mental state is a reflection of the physico-chemical state of the brain, which is part of the body) and also because many drugs which are physiologically addictive are psychologically addictive too - so a heroin addict wants to take more heroin both to satisfy the craving to repeat the high, and to stave off the onset of withdrawals.

[EscapeDummy]

So physiological and physical addiction are the same thing? Or rather one term is "more correct" than the other, but they refer to the same principle?

[ex-junkie]

even if something is not addictive, it still has abuse potential to someone with addiction issues.

amphetamines are of course addictive, because you get to a point where you cant function normally without them. swim feels it does take a little longer for the amphetamine addiction to kick in, in the sense that it takes around a month before you get hooked. heroin is just crazy, cause you can have an addiction in a week.

anyways back to where swim started... swim has abused nitrous, ecstasy, ginseng, marijuana briefly, acid, heroin, methadone, amphetamines, methamphetamines, benzos briefly, fantasy, and holy fuck shes sure theres more but shell stop at that.

all of the above had differing consequences, and altered her life in one way or another- both physically and psychologically; obviously the ginseng being the least affecting one- all though she did end up with a massive migraine headache that lasted two weeks. still a result of abusing it though eh.

the psychological is a tough one to address, cause it can be changed quite easily. your thoughts create your world, only some people fail to put it into practice. no matter how far up shit creek you are, you can still make positive affirmations to boost your mind/life into a better place. even if theres nothing to be grateful for, theres nothing stopping anyone being grateful for what is yet to come... what is yet to come usually depends on your own outlook, and if its a negative one, thats what youll get.

[ex-junkie]

Originally Posted by Routemaster Flash

How the hell do you 'abuse' ginseng? I mean, what does it even do?

And WTF is 'fantasy' - d'you mean you got *seriously* into the Harry Potter series?

vials of oral ginseng. youre only supposed to have 1 of those in a day. well swim would take 15 of them. it increases your heart rate, makes you chew your face off, sweat, etc. that amount of ginseng is like eating a spoon full of amphetamines.

fantasy is ozzi slang for GHB.

**peking royal jelly panax ginseng "sports formula"= 10mL oral liquid vials. each 10mL dose is equivalent to dry panax gingseng root 2g= 2000mg and schizandra chinesis fruit 100mg.



WARNING: NOT TO BE TAKEN BY ASTHMA AND ALLERGY SUFFERERS. THIS PRODUCT CONTAINS ROYAL JELLY WHICH HAS BEEN REPORTED TO CAUSE SEVERE ALLERGIC REACTIONS AND IN RARE CASES, FATALITIES, ESPECIALLY IN ASTHMA AND ALLERGY SUFFERERS.

[Spucky]

Mmmmh,

there are two Main-Theories about Addiction:
1. "The Hijacked Brain" Theory
2. "Self-Medication, Pathway to Addiction"

Both have two different approach but are the current Method,
if we find a definition for us we can easy`r discuss the Topic!

Both Theory can be found inside of the Brainstorm-Files on the Webpage or via Scroogle!

http://www.atforum.com/cgi-bin/searc...hijacked+brain

[missparkles]

Swim is new to this forum.
But her own take on this complex subject is that long term addiction is a way of dealing with painful personal issues, until there's another healthier option available.
Stopping anything is painful, physically and psychologically.
Physically because swims body needed to re-adjust and work on it's own (unassisted, so to speak) and psychologically because swim needed to learn new skills to cope with life, substance free.
Swim doesn't know in depth why, just that it was this way for her.
But swim is enjoying learning about it.
Thanks all.

Reputation Comments on this post:

Great explanation, simple and to the point